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People with learning disabilities still face inequalities in access to health services. This article, which comes with a handout for a journal club discussion, sums up what nurses can do to reduce these inequalities

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People with learning disabilities still face inequalities in access to health services. This article, which comes with a handout for a journal club discussion, sums up what nurses can do to reduce these inequalities

“We need to plan creatively to solve growing healthcare needs”

First, I have to get this off my chest. It isn’t a heat wave when it only lasts a day and a half and then gets cloudy. It’s a British summer. We’ve had them before, not every year, obviously, but we have definitely had them.

When they have to cancel trains because of the weather it is not because of the unprecedented heat; it is because of the rubbish railway system.

If roads are melting in temperatures of over 27 degrees it is less to do with unexpected weather and more to do with the fact that making roads with chocolate was a bad idea.

Do you ever wonder if we sometimes drift towards a sort of collective cognitive dissonance whereby we know something absolutely to be true, like “it gets hot in summer”, yet claim to be surprised by a sunny day and complain about it being too hot?

And then we go to Spain on holiday where it was 41 ° C last week and the trains worked and the roads didn’t melt.

“We seem increasingly prone to forgetting things that we know very well”

We seem increasingly prone to forgetting things that we know very well. Like summer is hot, most British sport is characterised by plucky defeat and that we have an aging population who require healthcare.

Earlier this month, dementia was in the news because of concerns about the level of support that people who have the disease and their carers get from the NHS and social services. Doctors say this means referring patients is pointless and, as a consequence, families are increasingly having to find ways of absorbing need in sometimes difficult or impossible circumstances.

“We know the problems we face today will be bigger in 10 years, bigger still in 20 and 30 years”

Now we know that we have an ageing population and that complex and long-term healthcare needs, including dementia, are growing. We also know that trajectory is set, don’t we? We know the problems we face today will be bigger in 10 years, bigger still in 20 and 30 years. So I wonder why we are not planning more creatively than we seem to be.

Why, if I can strangle the weather metaphor, are we still building roads with the wrong stuff and buying the wrong sorts of trains?

There are at least two reasons why we are avoiding a fuller more open debate. The first is that, from a governmental perspective, it is easier to slowly change the cultural and behavioural expectations of the population than it is to negotiate with them.

“From a governmental perspective, it is easier to slowly change the cultural and behavioural expectations of the population than it is to negotiate with them”

By calling the withdrawal of public services ‘austerity’ (as opposed to class war) and claiming it is an economic necessity that we voted for, social expectation is redesigned isn’t it?

People absorb more difficulty into their lives as individuals because the collective has decided they must. And if you challenge that, if you want more help, you can be judged as morally diminished.

You are not prepared to do more for your father with dementia? You expect the state to do it for you? You are not viewed with sympathy; you will be judged. The gaze has become less soft.

“Europe is laced with some fantastic, creative, innovative dementia services”

The second reason we avoid debate is that the debate is too hard. It asks us questions about what sort of society we want to live in and what sort of society we are prepared to pay for, and that is a bit like wanting a nice hot summer but not liking it when we get sweaty. It invites contradiction.

Europe is laced with some fantastic, creative, innovative dementia services that could drive care forward and make delivery more affordable if we felt able to invest and develop for the future.

In the meantime, let’s not act too surprised if it rains this winter.

Mark Radcliffe is senior lecturer, and author of Stranger than Kindness. Follow him on twitter @markacradcliffe

Have you seen or heard of a TV programme called The Walking Dead? Premised on the idea that you could fall asleep and wake up to find that most of humanity had turned into slow-moving and wholly uncommunicative flesh-eating zombies, it is very popular among young people and to my old eyes quite hard to watch.

Nursing is a funny old muffin. It’s spent 20-odd years turning itself into a profession, edging along the park bench of jobs towards the doctors and the teachers, and away from the oddly dressed vocations like the performance artist or nun. Yet somehow it never fully arrives, does it?

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